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APPLICATIO�. FOR CONSTRUCTI -� N PEI�WIIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPART�AE!VT HEATING SYSTEM: J 3AS J ELECTRIC J -� <br /> 259-8810 <br /> ❑ DEMOLITION ! I COMBINATION I ' BUILDING I�MECHANICAL �PLUMBING ; ; SIGN <br /> OWNER MAtLA�DR[55 ^ iv ZiP PHON- <br /> � <br /> � �t.��Sc �. .�710'> r���c;�..,. +s3.t �7 �?�1 <br /> i[NANT MARADDRE55 OTV ZIP PHOt:E <br /> ARCMITEGTORpE51GFlER MAILADDRESS QiV ZIP PHONE <br /> GENERALCONTR0.CT�R M41LA0[1PE55 CITV IIP PNONE STAT[LICENSE� <br /> 1"CNANiC�LCONiFI.f MAILpDDqE55 CITV ZiP PHONE SiATEIICENSEJ <br /> �.�,.,c�r�.1� <br /> PL'JMBINGCU OR MAtLA�DNESS CITV ZIP PHONE STATELICENS R <br /> LJE��,�:c t,�...���, �Scec�c.. �G �.>or �'7/'Glr�n,F'c..c<<-'-r'z �:�7.2�iY5's't7 �� fti.�9[:7 �Cv <br /> CONTRAGi PRICE OF WORK <br /> DESCRIBE WORK ANO SOUAP[F00`r1GE INVOLVE� LGNTqCT PERSON ANp PHONE NO. <br /> I HERE6Y CERTIFV �HAT t HAVE READ AND E%AMINED THIS <br /> PROPOSEDIISEOFBUILDING APPLICATION AND KNOW THe SAME TO RE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANC :5 G'JVERNING THIS TYPE OF <br /> �e�n��escaianorvorvporeatv�sHnwrvee�owoannncNnvocoriesi WORK WIIL BE COMPLIcTED WITN WHEINER SPECIFIED HEREIN OR <br /> NOT. THE GRANTIN.ri CF A PERA7IT DOES NOT PRESUME TO GIVE <br /> ior e�ocr, oF - AUTHORITY TO VIC`LATE OF ;ANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCf l I SW(iEGULATING CONSTRUCTION OR THE <br /> — PERFORMANCE OF CON>TRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPEr7N TO PERFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATt <br /> enece�rnx i.o.nun+eea CONTRACTOR W 1827 RCW AND 296.200 WAC. <br /> CONSTRUCTIONLORNLENDER.AODRESS,TEL[PHOYFNUMBE� <br /> / �j � / C' � <br /> � .J <br /> PROJECTADDRESS snrv �a � o.�c <br /> 2��� � cirrousw�ssi•cFrvseao -- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATF.R CLOSET(TOILET) A/C-0.�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYS7EAIS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHES DfiYERS —T <br /> KITCHEN SINK 8 OISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TP.AY WATER HEATER ' <br /> CLOTHFS WASHER VlOOD STOVE � <br /> URINAL METAL FlfiEPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIAEPLAC[ INSERT � <br /> FLOQR DRAIN HEAT Pl1MP <br /> BACKFLGW PREVENTERS GAS PIPMG ; <br /> ROOF DFlAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR.ETQ) <br /> _ _T <br /> SUB TOTAL 5 SIJB TOTAL 5 r <br /> _ PERMIT S _/��;� FERMIT $ <br /> TCTALFEE S TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> PRON15EiBRCN R[Fq5[i�ACK $I�ESETPALK PIANLH[CHl:NdOEfi (e[ R[C[IPT110. <br /> use zor+e �oT aaen vncnNr siTe FEES VALUATION FEE <br /> � - VES .. NO pU1LDING <br /> 7YPEOFCONSI. NOOFSTOniEs m.ar.nuv toa�er.ie•��,;�,�.; -- — — — <br /> p49" . PLUMBING ' <br /> SRE Of BLDG FlRE SPRINKL[FS REO'D BASEMENT � <br /> MECHANICAL <br /> � � YES ' �. NO <br /> OCCUrqNCVL0A0 �IR[ALARMREOD HBGIIiuMITATIUN �ODITIONALPLANCHECK <br /> I OTHER <br /> PERSOtJ <br /> STATE 6UILD�NG SURCHA9GE � <br /> INi�NEOY PLANSAPPROVEDBY CITi OFEVEflETT PUBLICWCRK$ ' <br /> LOCAL SALES <br /> ome TAX CODE IS 3105 rota� <br />